The demise of the university’s first “medical college” meant vacating its downtown quarters, right, and relocating to what was then the western edge of St. Louis, today known as the “Central West End,” along the north/south axis of Euclid Avenue.


VIDEO: The Flexner Report at Washington University School of Medicine: Rooted in the Past, Reaching for the Future

When Flexner Saw the Future

Origins and History of WUSM

The “New” Medical Center













“We hope that our efforts will contribute, in some measure, to raising the standard of medical education in the West.”
— Robert S. Brookings

During the 1909 Christmas season, Washington University’s board president, Robert S. Brookings, entertained a special visitor at his Lindell Avenue mansion: physician David L. Edsall, MD, a rising star in pharmacology at the University of Pennsylvania. Edsall had come to give Brookings and Chancellor David F. Houston some key advice, but his hosts had another sly purpose in showering him with attention. They wanted him to become the dean of their reorganized medical school.

Until a few months before Edsall’s visit, Brookings had no intention of rebuilding the medical school, though he knew it had flaws. After all, he had just depleted his energy and fortune in relocating undergraduates to the breathtaking Hilltop Campus. Then, in April 1909, Abraham Flexner paid a visit to the university, on behalf of the Carnegie Foundation for the Advancement of Teaching, and wrote a scathing critique of its medical school. It desperately needed new buildings, he said — and new faculty.

Where to recruit them? There was no doubt which direction they would look. In his report, a survey of 155 medical schools in the United States and Canada, Flexner had excoriated all but a handful of schools — and they were in the East. Yale. The University of Pennsylvania. Harvard. And towering above the rest, providing a model of enlightened medical education, was The Johns Hopkins School of Medicine.

Hatching a plan

In fact, Flexner himself was a graduate of Hopkins, as was his brother, Simon Flexner, MD, an eminent pathologist and first director of the young Rockefeller Institute for Medical Research. Simon and his Hopkins mentor, Dean William H. Welch, MD, had recommended the brilliant Edsall as just the adviser that Brookings and Houston needed. Abraham Flexner and his boss at the Carnegie Foundation — Henry S. Pritchett, PhD, once a Washington University faculty member and an old friend of Brookings — heartily agreed.

Fresh start: The North and South buildings under construction, 1913–14

So Edsall paid his visit to St. Louis. Even though he turned down the deanship, he spun a gossamer vision of the “total reconstruction” of the medical school along ideal lines. There would be great laboratories for research and hospital beds within easy reach. As to faculty, he told Brookings that if all the department chairs were filled at once “with first-class men,” Washington University “would without question occupy the commanding situation in the country.”

Brookings, a romantic at heart, was captivated by this picture. He reported to Pritchett that it was “a scheme of organization that would make the strongest aggregation of medical talent for school purposes ever gathered together in this or any other country.” But he was also a shrewd businessman, who knew better than academics what airy dreams could cost.

On the eve of a three-month trip to Egypt, Brookings made a decision: He would give $500,000 of the $850,000 needed for the new facilities and one-quarter of the school’s operating costs. He also authorized Houston to begin the search for the exciting young scientists they needed. And, as he admitted to Pritchett, he realized that his early largesse was “only the beginning.”

The men arrive

Before leaving the country, Brookings saw Edsall again and met with Harvey W. Cushing, MD, the noted Hopkins neurosurgeon, to gain his advice and persuade him to come. While Cushing agreed to visit, he finally decided to go to Harvard; however, he helped recruit other talented faculty. To pathologist Eugene L. Opie, MD, a Hopkins graduate now associated with the Rockefeller Institute, Cushing wrote: “You have been ticketed for the chair at the Washington University in St. Louis, provided their move can go through. … I have been out there myself and things look very promising. … Abraham Flexner says it is the only school in the country that has prospects of a sufficient endowment.”

Opie signed on, and so did another Hopkins graduate, Joseph Erlanger, MD, who would chair physiology. Heading pediatrics would be John Howland, MD, a Columbia graduate. And the new dean, rated by Welch as among the best clinical teachers and scholars in the country, would be George Dock, MD, a graduate of the University of Pennsylvania.

The old Washington University medical faculty members — well-respected local clinicians who had long hoped for reform — were largely gracious about these changes, though at least one protested angrily to Brookings. From this group, Houston and his advisers retained one Europe-trained physician as head of anatomy: the admirable Robert J. Terry, MD, who would remain on the faculty until 1966.

Nearly simultaneous with the construction of the School of Medicine’s new home, across the street Barnes Hospital also was taking shape.

They also would need a strong head of biological chemistry, and incoming faculty recommended Philip A. Shaffer, PhD, a Harvard graduate teaching at Cornell University’s medical school. Soon two others signed on: Fred T. Murphy, MD, another Harvard graduate, as head of surgery, and the previously reluctant Edsall, who now agreed to head preventive medicine.

Flexner and Pritchett were ecstatic with these developments. As Pritchett wrote to Brookings: “You have certainly got a stunning group of men together. I do not think the like is to be found in America.” Others were less star-struck, referring sardonically to the new faculty as the “Wise Men from the East.”

A lasting legacy

Talented they were, but these new recruits had egos as well as tempers — and problems quickly developed. Irritated that the promised new buildings did not materialize more quickly, Howland departed after six months and soon took a position at Hopkins; the mercurial Edsall left for a post at Harvard.

And the plan for an Executive Faculty, modeled on a similar body of department heads at Hopkins, quickly ran into trouble. Dock wished to use this group as his advisers, while the heads wanted Dock to implement their decisions. In 1912, the conflict reached a flashpoint and the Executive Faculty forced Dock out, though he stayed on the faculty until 1922. Opie took his place for three years, then Shaffer for another four.

But for the most part, these first faculty members lived up to their description as wise men, offering a rich array of gifts to the medical school. Opie became a distinguished researcher, remaining until 1923. Murphy went abroad during World War I, serving as first director of Base Hospital No. 21. Erlanger won the Nobel Prize in 1944; Shaffer stayed for 50 years, serving as dean twice and doing seminal work on insulin.

At the 1915 medical school dedication ceremony, Robert Brookings expressed his own dream for its future. “We hope that our efforts will contribute, in some measure, to raising the standard of medical education in the West,” he said, “and that we will add, though research activities, our fair quota to the sum of the world’s knowledge of medicine.” Thanks to the new faculty members and their successors, his fondest hopes would all come true.

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